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INSURANCE REQUIREMENT AFFIDAVIT <br />TO BE COMPLETED BY APPROPRIATE INSURANCE AGENT ~ <br />MUST BE RETURNED AS PART OF BID <br />I, the undersigned agent, certify that the insurance requirements contained in this bid <br />document have been reviewed by me with the below-identified <br />vendor/contractor/consultant/engineer/architect. <br />awardedithis the cont act by the Ci yeof <br />vendor/contractor/consultant/eng n eer/a c <br />Paris, I will be able, within ten (10) working days after being notified of such award, to <br />furnish valid insurance certificate to the City meeting all of the requirements contained <br />in thi id. <br />r r' ✓ l C~K ( ~~D <br />gent's Signature Agent Name (Print 1 <br />.7 <br />D . ~'.~r ~ ur ieC f.me/Lof Insrrier <br />I, n(~ Z-~f'~`` <br />dress of ~Iency T5 r~ <br />q IS 4 <br />State <br />7~ S-D ~ G -7 <br />,one Number <br />w . ~ <br />ame of VendorlContractor/Consultant/Engineer/Architect (Print or ype i~r~before me thiNotary Public, State of Texas <br />;F ~sMfy Commission Exp, 0&02-zot0 <br />this time requirement is not met, the City has the right to declare this vendor non-responsible and award <br />)ntract to the next lowest bidder meeting the specifications. If you have any quesrions concerning tb <br />